The Behavior of Two Types of Upper Removable Retainers-Our Clinical Experience.

The Hawley retainer (HR) and the vacuum-formed retainer (VFR) are the most common removable retainers in orthodontic treatments. The aim of this retrospective study was to comparatively analyze the behavior of two types of removable retainers-HRs and VFRs-in terms of retainer damage, loss, and the rate of installation of mild or severe relapse that required recourse to certain therapeutic interventions. The study was performed on 618 orthodontic patients aged 11-17 years, average age 13.98 ± 1.51, out of which 57% were patients having VFRs and the remaining 43% having HRs in the upper arch. We performed an analysis of the two groups of patients-HRs group and VFRs group-at 6 months (T1) and at 12 months (T2) after the application of the retainer. The results showed that 6% of all the retainers were damaged, mostly at T2 (54.1%). Seven percent of all the retainers were lost, mostly at T1 (58.1%). Of all the patients, 9.1% presented mild relapse, mostly at T1 (58.9%), while 2.6% presented severe relapse. The VFRs were significantly more frequently associated with the occurrence of damage than the HRs (p < 0.001). Severe relapse was more frequently associated with the HRs rather than with VFRs (p < 0.05).

An important morphological feature of the face: upper lip length.

The oral cavity, including the lips, is considered one of the most important features of the face, taken into consideration when people inter-relate. Upper lip, in particular, can have a great influence on the aspect of a smile, which is why its proportional length and thickness can improve a lot a persons' smile. The aim of this study was to determine the average length of the upper lip in the Caucasian population, considering age and gender. The average upper lip length determined on the lateral skull radiography was 20.25±2.555 mm. The average length of the upper lip was 19.79±1.641 mm in the age category under 12 years and 20.32±2.664 mm in the age category over 12 years. The average length of the upper lip was 19.95±2.4 mm in women and 21.18±2.79 mm in men. We can conclude that women have lower values, while men have higher values of the upper lip length, and that the younger the patient is, the shorter the length of the upper lip is. Moreover, the Caucasian population proved to have a shorter upper lip compared to the Asian or Negroid population.

Correction of Class III malocclusions through morphological changes of the maxilla using the protraction face mask by three different therapeutic approaches.

Face mask (FM) therapy used for maxillary protraction improves the facial profile in patients with Class III malocclusion. The aim of this study was to compare the sagittal morphological changes of the maxilla through three different therapeutic approaches, respectively using removable appliances (RA), rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME), each of them in combination with the FM therapy in growing and non-growing patients. The sample, consisting of 42 orthodontic patients aged 7-21, was divided into four groups, according to their age. The first group of patients, aged 6-9 (RA + FM group), received treatment with RA in combination with FM, the second group of patients, aged 10-13 (RME + FM pubertal group), received treatment with RME in combination with FM, the third group of patients, aged 14-16 (RME + FM postpubertal group), received treatment with RME and FM, and the fourth group of patients, aged 17-21 (SARME + FM group), underwent SARME in combination with FM. To assess the sagittal skeletal changes of the maxilla, the sella-nasion-A point (SNA) and A point-nasion-B point (ANB) angles were measured at the beginning and after the FM therapy. The differences in the evolution of the SNA angle between the groups were statistically significant (p<0.001). Post-hoc analysis showed that patients aged 6-9 had the highest evolution, statistically higher than patients aged 14-16 (p=0.007) or patients aged 17-21 (p<0.001). The evolution of the SNA angle was significantly higher in patients aged 10-13, in comparison to patients aged 17-21 (p<0.001). The efficiency of the FM therapy alone or associated with RME depends on patients' growing period. In non-growing patients, the FM therapy is efficient when associated with SARME.

Environmental Factors Associated with Malocclusion in Children Population from Mining Areas, Western Romania.

Our study is based on the hypothesis that the prevalence of malocclusions in children is higher in the mining areas from North-Western (NW) Romania than in other geographic areas. We also considered that the distribution of the different types of malocclusions can be correlated with environmental factors. Therefore, the main purpose of the current study was to assess the prevalence of malocclusions in children from the mining areas in NW Romania. Another purpose was to establish the influence of certain environmental factors such as gender, geographical area of origin, and ethnicity on the distribution of malocclusions in order to provide an epidemiological reference for the planning of preventive and treatment programs adapted to the particularity of the mining areas. This cross-sectional study was performed in 2015-2016. The study batch consisted of 960 children from the mining areas, aged 7-14 years, in the period of mixed dentition and early permanent dentition. The clinical examination was conducted by a single examiner, an orthodontic specialist (TBI), in order to avoid inter-operator bias. Occlusion was registered according to Bjoerk. Occlusal clinical signs were followed for the determination of malocclusions. Most children had malocclusions (93.5%). The percentage of anomalies was significantly higher in subjects from Rosia Montana, in girls, and in the Romanians. Data showed that Angle Class I was the most prevalent malocclusion (60.21%), followed by crowding (47.5%), midline shift (43.33%), and deep bite (28.65%). The independent association between ethnicity and total malocclusions shows that the Romanian subjects presented a 3.31 higher chance of developing malocclusions than the Romani ones. The presence of malocclusions was independently influenced by all the studied environmental factors, namely gender, geographical area, and ethnicity. Our results could be relevant for oral health policy-making, i.e., planning preventive and treatment measures of malocclusions, adapted to the peculiarity of the studied mining areas.

Correlations between morphology of cervical vertebrae and dental eruption.

The process of dental eruption is submitted to physiological and pathological variables. A series of discrepancies may occur, one of these being a disturbance between dental age and bone age. The assessment of bone age is best made with the cervical vertebral maturation (CVM) method, simplified by Baccetti et al. (2005). The sample studied consisted of 215 orthodontic patients. The dental age was assessed on the orthopantomograph radiographies and the bone age on the lateral cephalograms. For determining the bone age, CVM method was used. Considering dental age, most of the patients (50.2%) have a premature dental age compared to bone age, while patients with normal dental age (27.9%) and patients with late dental age (21.9%) have a lower frequency. The correlation between the dental age and the bone age of the patients shows that patients who have higher values of dental age also have higher values of bone age (p<0.001). The correlation between genders shows that female patients tend to have a higher average value of bone age in comparison to male patients (p<0.001). The authors conclude that assessing bone age based on the morphology of cervical vertebrae and correlating it with the dental age could be of great use in opting for a certain orthodontic treatment plan.

Non-syndromic hypodontia of permanent dentition associated with other dental anomalies in children and adolescents.

Anomalies of permanent dentition, by the frequency of the cases, also correspond to some unanimously recognized problems of public health. The objective of this study is to determine the prevalence of non-syndromic hypodontia and oligodontia and to identify the types of associated dental anomalies in the permanent dentition of children and adolescents in the NW of Romania. The study was conducted between 2008 and 2015 on a group of 566 children aged between 12-18 years old. Dental agenesis was diagnosed using clinical and radiological criteria. The numbers and types of teeth missing were noted. Third molars were excluded. Hypodontia had a prevalence of 2% in girls and 3.76% in boys (p=0.007), and oligodontia of 0.33% in girls and 0.38% in boys (p=0.367). Unique abnormalities were registered at 1% in girls and 1.5% in boys (p=0.026), those with two associations at 0.67% in girls and 1.5% in boys (p=0.015), and those with triple association at 0.67% in girls and 1.13% in boys (p=0.037). Hypodontia∕oligodontia has been identified in association with other dental abnormalities, such as inclusion, microdontia, and enamel hypomineralization. The most frequent was the association of hypodontia with enamel hypomineralization.